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Individual

JOHN A AZZATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1513 N HOWE ST STE 4, SOUTHPORT, NC 28461-2770
(910) 805-5578
Mailing address
PO BOX 11515, SOUTHPORT, NC 28461-1515
(910) 454-8030

Taxonomy

Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
20698
NC
207X00000X
Orthopaedic Surgery Physician
Primary
20698
NC
208D00000X
General Practice Physician
20698
NC
2251X0800X
Orthopedic Physical Therapist
20698
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8912440
NC
Enumeration date
07/17/2006
Last updated
08/26/2021
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